RN Utilization Review Case Manager – ED

Written by jcampbell - - Comments Off on RN Utilization Review Case Manager – ED
Mount Carmel Hospital
Published
November 19, 2020
Location
Columbus, Ohio
Job Type

Description

-
nursing-jobs

RN Utilization Review Case Manager - ED

Location Grove City, Ohio, 43123 Category Nursing Job Id 00233999
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Employment Type:

Full time

Shift:

Evening Shift

Description:

Utilization Review, RN - ED

Why Mount Carmel?

With five hospitals, over 60 free-standing outpatient clinics, a college of nursing, a Medicare Advantage plan, and extensive outreach and community wellness programs, Mount Carmel Health System serves more than a million patients in central Ohio each year, and we've been a pillar of this community for more than 130 years. As a proud member of Trinity Health, one of the nation's largest Catholic healthcare delivery systems, our network of caring spans 22 states, 94 hospitals, and 133,000 colleagues nationwide.

We know that exceptional patient care starts with taking care of our colleagues, so we invest in great people and all that we ask in return is that you come to work ready to make a difference and do the right thing.

What we offer:

  • Competitive compensation and benefits packages including medical, dental, and vision coverage
  • Retirement savings account with employer match starting on day one
  • Generous paid time off programs
  • Employee recognition incentive program
  • Tuition/professional development reimbursement
  • Relocation assistance (geographic restrictions apply)
  • Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing

About the job:

The RN Case Manager, Utilization Review ensures that services are delivered in a manner that balances quality of care with efficiency, cost-containment and compliance.

What you'll do:

  • Conduct Utilization Management review for Inpatient and Outpatient cases.
  • Analyze, summarize, and concisely report medical utilization and medical chart audit results.
  • Compare clinical information to determine appropriateness of service and to document all related information according to department policies and procedures.
  • Coordinate with the utilization review, case management, and discharge planning colleagues as needed.
  • Collaborate with medical directors/providers and other operational departments such as Claims, Denials, etc. regarding applicable case-specific issues.

What we're looking for:

  • Graduate of an accredited school of nursing.
  • Licensure / Certification: Current license to practice as a Registered Nurse (RN) in the State of Ohio.
  • Experience: Three (3)+ years of relevant clinical work experience required; Two (2)+ years' experience in utilization review, discharge planning, or case management preferred.

--

Mount Carmel and all its affiliates are proud to be equal opportunity employers. We do not discriminate on the basis of race, gender, religion, physical disability or any other classification protected under local, state or federal law.

Trinity Health's Commitment to Diversity and Inclusion

Trinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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